Costs of health care | June 28 2010

Costs of health care

Today’s message is getting away from my usual description of a law-related news event. This time I would like to tell about an incident which happened to me this past Friday.

During my customary early morning workout at the gym my tongue began to swell, and by the time that I got home it was enlarged to the point where I could no longer speak or swallow. We waited until 7:30 for the clinic to open, and then my wife, Betsy, went with me to see my primary care physician.

The doctor said that since I could not swallow I would have to go to the hospital to get Benadryl intravenously. He called the hospital to say I was coming and then totally surprised me by announcing that the hospital was sending an ambulance! Pretty soon eight large young men, four firemen and four EMT’s, appeared with all sorts of equipment, including a stretcher. With the exception of my swollen tongue I was feeling just fine, but after some resistance I reluctantly agreed to go in the ambulance. When we got outside there was not only an ambulance there, but also a large fire truck.

Once in the hospital I was placed in a holding room which is a part of the ER. This room was equipped with all sorts of advanced-technology equipment, I’m guessing worth a few hundred thousand dollars.

Over the course of the next few hours I was seen by five different doctors and numerous nurses, a phlebotomist and a social worker, each one requiring that I relate all that had happened (my tongue had deflated enough by then so that I could speak), a list of my meds, my medical history, etc. In addition to the IV which had been installed in the ambulance blood samples were taken three different times for various tests. My blood pressure, temperature and heart rate were taken every two hours. I was finally allowed to leave the hospital at around 8:00 p.m. by which time the swelling had pretty much disappeared.

The astounding thing about this experience is the tremendous amount of waste that goes into health care. Whether or not I needed to be transported the five-minute trip from the clinic to the hospital is questionable, but in any case eight men and a large fire truck in addition to the ambulance were clearly not needed.

Although I regularly see hospital bills in my work representing injured people and am fully aware of the high costs of medical care, this was an eye-opener for me. It is obvious that the approach to health care in our country is to provide whatever treatment might be applicable “just in case”. There may have been only a chance in a thousand that my airway would have swollen shut on the way to the hospital, but that somehow justified the expense of eight firefighters with all of their equipment and vehicles. I didn’t need to see five different doctors. I did not need to see a social worker. I did not need to have my blood drawn three times. My blood pressure was not an issue, so taking it every couple of hours was wasting personnel time. I could have done as well in a plain room with a comfortable chair. In fact by the time that I arrived at the hospital and before any medication was administered my tongue had already begun to shrink. If simply left alone, I would no doubt have recovered just as quickly as I did with thousands of dollars worth of care.

The question which comes to mind is: Can we afford to provide medical care on a “just in case” basis? More limited care, based on the probability of doing some good, could mean that a few people, but only a very tiny fraction of patients, might suffer injury or death which could have been prevented. The cost of saving these few, however, is enormous. If we would limit health care to a reasonable level, we might well be better able to afford to treat the thousands of our citizens who now get no treatment at all.